title: Psychological traits influence autonomic nervous system recovery following esophageal intubation in health and functional chest pain.
abstract: BACKGROUND
  Esophageal intubation is a widely utilized technique for a diverse array of physiological studies, activating a complex physiological response mediated, in part, by the autonomic nervous system (ANS). In order to determine the optimal time period after intubation when physiological observations should be recorded, it is important to know the duration of, and factors that influence, this ANS response, in both health and disease.
  
  
  METHODS
  Fifty healthy subjects (27 males, median age 31.9 years, range 20-53 years) and 20 patients with Rome III defined functional chest pain (nine male, median age of 38.7 years, range 28-59 years) had personality traits and anxiety measured. Subjects had heart rate (HR), blood pressure (BP), sympathetic (cardiac sympathetic index, CSI), and parasympathetic nervous system (cardiac vagal tone, CVT) parameters measured at baseline and in response to per nasum intubation with an esophageal catheter. CSI/CVT recovery was measured following esophageal intubation.
  
  
  RESULTS
  In all subjects, esophageal intubation caused an elevation in HR, BP, CSI, and skin conductance response (SCR; all p < 0.0001) but concomitant CVT and cardiac sensitivity to the baroreflex (CSB) withdrawal (all p < 0.04). Multiple linear regression analysis demonstrated that longer CVT recovery times were independently associated with higher neuroticism (p < 0.001). Patients had prolonged CSI and CVT recovery times in comparison to healthy subjects (112.5 s vs 46.5 s, p = 0.0001 and 549 s vs 223.5 s, p = 0.0001, respectively).
  
  
  CONCLUSIONS
  Esophageal intubation activates a flight/flight ANS response. Future studies should allow for at least 10 min of recovery time. Consideration should be given to psychological traits and disease status as these can influence recovery.
authors.affiliation: Centre for Digestive Diseases, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Farmer
authors.forename: S J
authors.initials: SJ
authors.lastname: Coen
authors.forename: M
authors.initials: M
authors.lastname: Kano
authors.forename: S F
authors.initials: SF
authors.lastname: Worthen
authors.forename: H E
authors.initials: HE
authors.lastname: Rossiter
authors.forename: H
authors.initials: H
authors.lastname: Navqi
authors.forename: S M
authors.initials: SM
authors.lastname: Scott
authors.forename: P L
authors.initials: PL
authors.lastname: Furlong
authors.forename: Q
authors.initials: Q
authors.lastname: Aziz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001341:Autonomic Nervous System / Q000502:physiology*; D002637:Chest Pain / Q000523:psychology; D004947:Esophagus; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010551:Personality; D013312:Stress, Physiological; D055815:Young Adult
keywords: anxiety; autonomic nervous system; esophageal intubation; functional chest pain; neuroticism